What causes a Urinary Tract Infection?
A Urinary Tract Infection, or UTI, is caused by bacteria growing in the bladder. In a Spinal Cord Injured person, the two most common causes of a UTI are inadequate bladder emptying and self-catheterization. Bacteria multiplies in dark, moist, warm places - a perfect description of a bladder! If the bladder is not drained adequately, bacteria will flourish. Any time anything is inserted into the bladder (a catheter, a cystoscope), there is a chance of infection. Because of this, good hygiene is always needed prior to catheterization. Whether a person is using clean technique or sterile technique, the area surrounding the urethra must be cleaned thoroughly to minimize the amount of bacteria being introduced into the bladder. Of course, if catheters are being reused, check with your physician for advice on sanitizing the catheters.

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Should I always call my doctor when I think I have a Urinary Tract Infection?
Yes. Spinal Cord Injured people obviously have a decreased sensation to the area which would otherwise feel discomfort when a UTI is present. Your doctor may test the urine to determine if there is a UTI present or to what extent the bladder is infected. It is more effective to treat an infection in its early stages than when it becomes rampant. UTIs can spread outside the bladder to the kidneys and into the bloodstream, which can be very
detrimental to your well-being. Not all UTIs need to be treated with antibiotics, but it is best to have your doctor, who knows your situation, make that decision.

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What can I do to help prevent pressure sores (decubitus ulcers)?
Yes. What seems like an insignificant pressure area can become a major problem very quickly. Because of a Spinal Cord Injured person's decreased sensation, observation and prevention are both necessary to prevent or minimize problems associated with pressure areas. A few suggestions are:

1. Make certain that clothing is not creased. Creases can increase pressure at the point of contact and cause the skin to break down.
2. Showering regularly will keep the skin's bacteria count under control in case the skin does begin to break down, which in turn could prevent a major infection.
3. While sitting in your wheelchair, relieve pressure by raising your body in what is better known as a "pressure lift." This should be done every 20-30 minutes for 15-30 seconds at a time. If in bed, pressure points (buttocks, ankles, elbows, etc.) need to be relieved every hour.
4. Make certain the cushion in your wheelchair is initially fitted properly by a Physical Therapist. The pressure in the cushion needs to be adequate to prevent "bottoming out" which can cause disproportionate pressure.
5. Self "skin checks" should be done daily with an extension mirror. If you see a change in color, notify your physician immediately. If you have a Caretaker, make certain he or she is checking daily and that any suspicious area is shown to you so you will be aware of the change from day to day.
6. Nutrition is a major factor in good skin care. Protein is needed to build and maintain strong tissue.
7. Keep well-hydrated. Good skin turgor is a critical part of skin well-being.
8. Lastly, but also very important, is to report any skin sensations that are unusual to you. Sometimes the beginning of skin breakdown is noticed as an unusual sensation, particularly in an area of constant pressure.

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